title: Pregnancy nutritional indices and birth weight after Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Maternal metabolic profile and nutritional course of pregnancy after bariatric interventions is incompletely known. Their impact on birth weight has also not been hitherto addressed. Aiming to document such variables, a retrospective study was undertaken.
  
  
  METHODS
  Women previously submitted to silastic ring Roux-en-Y gastric bypass, who conceived after 0-5 years (n = 14), were investigated. Intake of selected macro- and micronutrients, representative laboratory measurements, and correlation of these findings with birth weight and time to conception was documented.
  
  
  RESULTS
  Mean calorie intake was restricted to about 1,800 kcal/day. Protein (71 +/- 17 g/day) and supplementary iron (60 mg/day) were barely adequate, and calcium and vitamin B(12) did not meet current recommendations, only folic acid being optimal. Biochemical monitoring reflected these inconsistencies, with occasional low values for serum albumin (4.1 +/- 0.4 g/dL), hemoglobin (11.4 +/- 1.5 g/dL), iron (78 +/- 50 mug/dL) and vitamin B(12) (193 +/- 102 pg/mL) but not folate. Lipids, glucose, and uric acid were much better than before the anti-obesity intervention. Reduced plasma lipids, glucose, and uric acid were associated with larger birth weight, albeit within the normal range.
  
  
  CONCLUSIONS
  (1) Anemia as well as additional nutritional deficits during pregnancy were not totally eliminated, despite dietary guidance and micronutrient supplementation; (2) alleviation of metabolic comorbidities was demonstrated, and improved normalization predicted higher birth weight; (3) energy and folate intake was sufficient, but other nutrients probably did not reach ideal levels; (4) recent dietary guidelines for this population represent a step forward, but additional studies are needed.
authors.affiliation: Nutrology Group, Hospital das Clinicas, Avenida Eneias C Aguiar 255-9th Floor, Rm 9077, Sao Paulo, Sao Paulo, 05403-900, Brazil. jfaintuch@hcnet.usp.br
authors.forename: Joel
authors.initials: J
authors.lastname: Faintuch
authors.forename: Maria Carolina Gonçalves
authors.initials: MC
authors.lastname: Dias
authors.forename: Eliener
authors.initials: E
authors.lastname: de Souza Fazio
authors.forename: Fernanda Castello Branco Mariz
authors.initials: FC
authors.lastname: de Oliveira
authors.forename: Roseli Mieko Yamamoto
authors.initials: RM
authors.lastname: Nomura
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
authors.forename: Ivan
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D015331:Cohort Studies; D002149:Energy Intake; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007231:Infant, Newborn; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000503:physiopathology* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011256:Pregnancy Outcome; D039401:Prenatal Nutritional Physiological Phenomena; D012189:Retrospective Studies; D013997:Time Factors